A Randomized Placebo-Controlled Trial of Intermittent Preventive Treatment in Pregnant Women in the Context of Insecticide Treated Nets Delivered through the Antenatal Clinic 英文参考文献.docVIP

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A Randomized Placebo-Controlled Trial of Intermittent Preventive Treatment in Pregnant Women in the Context of Insecticide Treated Nets Delivered through the Antenatal Clinic 英文参考文献.doc

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A Randomized Placebo-Controlled Trial of Intermittent Preventive Treatment in Pregnant Women in the Context of Insecticide Treated Nets Delivered through the Antenatal Clinic 英文参考文献

ARandomizedPlacebo-ControlledTrialofIntermittent PreventiveTreatmentinPregnantWomenintheContext ofInsecticideTreatedNetsDeliveredthroughthe AntenatalClinic ClaraMene′ndez1,2*,AzucenaBardaj?′1,2,BetuelSigauque2,3,Cleofe′ Romagosa1,2,SergiSanz1 ,Elisa Serra-Casas1,EusebioMacete2,4,AnnaBerenguera1,2,CatarinaDavid1,4,CarlotaDoban?o1,2 ,Denise Naniche1,AlfredoMayor1,JaumeOrdi1,InacioMandomando2,4,JohnJ.Aponte1,2,SamuelMabunda4, PedroL.Alonso1,2 1Barcelona Center for International Health Research (CRESIB) and Department of Pathology Hospital Clinic, Institut d’Investigacions Biomedicas August Pi i Sunyer (IDIBAPS),UniversitatdeBarcelona,Barcelona,Spain,2TheManhic?aHealthResearchCenter(CISM),Maputo,Mozambique,3NationalDirectorateofHealthandNational MalariaControlProgram,MinistryofHealth,Maputo,Mozambique,4NationalInstituteofHealth,MinistryofHealth,Maputo,Mozambique Abstract Background: Current recommendations to prevent malaria in African pregnant women rely on insecticide treated nets (ITNs) and intermittent preventive treatment (IPTp). However, there is no information on the safety and efficacy of their combineduse. Methods: 1030 pregnant Mozambican women of all gravidities received a long-lasting ITN during antenatal clinic (ANC) visits and, irrespective of HIV status, were enrolled in a randomised, double blind, placebo-controlled trial, to assess the safetyandefficacyof2-dosesulphadoxine-pyrimethamine(SP).Themainoutcomewasthereductioninlowbirthweight. Findings: Two-dose SP was safe and well tolerated, but was not associated with reductions in anaemia prevalence at delivery (RR, 0.92 [95% CI, 0.79–1.08]), low birth weight (RR, 0.99 [95% CI, 0.70–1.39]), or overall placental infection (p=0.964). However, the SP group showed a 40% reduction (95% CI, 7.40–61.20]; p=0.020) in the incidence of clinical malariaduringpregnancy,andreductionsintheprevalenceofperipheralparasitaemia(7.10%vs15.15%)(p,0.001),andof activelyinfectedplacentas(7.04%vs13.60%)(p=0.002).Therewasared